BLOOD. 305 



The composition of the blood in hypinosis is essentially the 

 reverse of that in hyperiuosis. The amount of corpuscles is in- 

 creased, that of fibrin diminished, and the solid constituents 

 generally are increased rather than diminished ; while in the 

 phlogoses they are most commonly below the normal standard. 

 We have seen in the previous analyses that in proportion as 

 the febrile symptoms assumed the form of erethismus, the cha- 

 racters of hypinosis became less marked; and, on the other hand, 

 that when they took on a torpid type these characters were more 

 strikingly developed. 



If we assume that the circulation of the blood is accelerated 

 in inflammatory fever, we may regard it as impeded in torpid 

 fever. In the one case, the blood abounding in fibrin acts 

 as an increased stimidus to the heart ; in the other, the heart 

 partially loses its power of action. Its contractions succeed each 

 other, it is true, with increased rapidity, but the blood-wave, 

 propelled at each systole, is diminished and powerless, and the 

 pulse, although much quickened, is small and wiry. 



In consequence of the delay thus occasioned in the motion of 

 the general mass of the blood, oxygen cannot act so efficiently 

 on it as in the normal state of the circulation, and consequently 

 the blood does not possess the bright red colour observed in in- 

 flammatory affections, but is dark, and the temperature, in- 

 stead of being increased, is often diminished, as has been ob- 

 served by Schonlein, in typhus. Hence the metamorphosis of 

 the blood, instead of being accelerated, as in hyperiuosis, is 

 impeded, and consequently the ratio of the corpuscles to the 

 albumen is reversed. In abdominal typhus, the amount of the 

 corpuscles is rendered more striking, by the diminution of albu- 

 men, which constituent is removed from the blood by the profuse 

 diarrhoea that accompanies this disease. 



From these observations it is very probable that the primary 

 cause of this modification of the blood maj', in a great measure, 

 be referred to the impeded circulation, and to the deficient 

 energy of the heart's action, w^hich may be regarded as indica- 

 tions of the depressed natality of the blood itself; but at the 

 same time the influence of the nerves on its composition and 

 on the circulation (although how they act we know not) must 

 not be overlooked. 



Finally, it must be observed that the state of hypinosis is 



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